■ When forming the pocket for the subsequent implant, it is important to dissect sufficiently in the cranial and medial directions, in order to obtain a soft, inconspicuous transition of the implant margin. In the medial direction, one should ensure that there is no connection between the sites of the left and right implants. There should be a safety margin of at least 3 cm, since otherwise there will not be a good aesthetic result.
■ In addition, when carrying out blunt dissection, one should ensure that the pocket is not taken too far in the lateral direction, since this could cause the bed of the implant to be too big laterally, producing separation of the breasts, i.e., they slide to the side and the result is not good. It is important that the breast "stands" and that in the lower neckline, the medial, cranial margin is well positioned, without the implant or the margin of the implant being discernible. The art of implant surgery is to create an implant site that constitutes an optimum precondition for the implant.
As a result of the prior tumescence, detachment of the gland from the fascia is trouble-free. The boundaries must be smooth in all directions and they must be sufficiently extensive so as not to cause later creasing
•2 of the implant. If the dissection using the middle or index finger as a fB
blunt instrument in the medial and cranial part is not completely suc-£ cessful, this dissection may be completed using Metzenbaum dissecting
¿g scissors with the illuminated retractor. Pushing to the side can easily be tj performed bluntly.
■ The implant compartments must be identical to the marking lines that were drawn before the operation. It should be ensured that the two implant pockets are symmetrical and the same size. Consequently, before incorporating implants, both the implant sites should be examined very precisely and hemostasis should be carried out twice using the bipolar tweezers.
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